Violence in the NHS

We examine staff and patient experiences of violence in the NHS.

Indicator

Last updated: 29/01/2020

Safety
Primary and community care Hospital care Emergency care Mental health

Background

The NHS Constitution sets out the rights and responsibilities of patients, the public and staff to ensure the NHS operates fairly and effectively. The staff pledges define what the NHS expects from staff and what staff can expect from NHS employers. One of the pledges is to provide support and opportunities for staff to maintain their health, wellbeing and safety. Patients and the public have the right to be cared for in a safe and secure environment and the responsibility to treat NHS staff and other patients with respect.

Health and social care employees have had a consistently higher risk of violence at work than other occupational groups in recent years. Incidents may be underreported due to a lack of confidence in the reporting process or an acceptance that it is part of the job. The first NHS violence reduction strategy was launched in 2018, aiming to protect the NHS workforce from violence and aggression from patients, their families and the public. It also sets out to provide mental health support for staff who are victims of violence, and ensure quick and effective punishment for offenders.


What proportion of staff say that they have experienced physical violence at work from patients and the public? 29/01/2020

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Source:  

NHS Staff Survey

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What proportion of staff say that they have experienced physical violence at work from managers or other colleagues? 29/01/2020

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Source:  

NHS Staff Survey

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The NHS Staff Survey asks respondents if they have experienced physical violence at work from patients, their relatives, and the public in the past 12 months. It also asks if they have experienced violence from managers or other colleagues. Fewer respondents reported violence from managers or other colleagues (2.2% in 2018) than from patients and the public (14.5% in 2018).

Staff in ambulance trusts are consistently the most likely to face violence from patients and the public, with 33.3% of respondents in 2018 saying they had experienced at least one incident in the past 12 months, followed by 20.2% of staff in mental health and learning disability trusts. In 2018, 7.4% of staff in community trusts  and 6.5% of staff in acute specialist trusts said that they had experienced violence from patients and the public. The percentage of staff in different trust types who say they have experienced violence in the past 12 months have remained fairly constant over the time period.

Between 2015 and 2018, the overall percentage of respondents who said they had experienced physical violence from managers or other colleagues at least once in the past 12 months decreased from 2.5% to 2.2%. Staff in mental health and learning disability trusts report the most violence, with 2.5% in 2018 saying they have experienced at least one incident in the past 12 months. This compares to 1.1% in community trusts.


How often do staff say that they experience violence from patients and the public? 29/01/2020

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Source:  

NHS Staff Survey

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While a higher percentage of staff in ambulance trusts report at least one incident of violence from patients and the public in the past 12 months, those in mental health and learning disability trusts are more likely to be subject to multiple incidents of violence. In 2018, 3.4% of respondents in mental health and learning disability trusts said they had experienced violence more than 10 times in the past 12 months. This is over 2.5 times the national average.


How has the proportion of staff who report incidents of violence changed over time? 29/01/2020

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Source:  

NHS Staff Survey

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The NHS Staff Survey asks respondents whether the last incident of physical violence they experienced at work was formally reported either by themselves or by a colleague. Between 2014 and 2018 the overall percentage of respondents who say that the last incident was reported decreased from 73.1% to 71.5% (data not shown).

Staff in mental health and learning disability trusts are the most likely to have reported, with 92.3% of respondents in 2018 saying that the last incident of violence was reported either by themselves or a colleague. This compares to 66.2% of staff in acute trusts. The percentage of staff who said the last incident of violence was reported stayed constant or decreased over the time period for all trust types except for ambulance trusts, where reporting increased from 65.4% in 2016 to 69.3% in 2018.


How has the proportion of patients feeling threatened in A&E changed over time? 29/01/2020

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The Urgent and Emergency Care Survey asks respondents if they felt threatened by other patients or visitors while they were in A&E. The percentage of respondents who replied that they ‘definitely’ or ‘to some extent’ felt threatened decreased from 11% in 2003 to 7% in 2014. Due to changes to the survey methodology, results pre- and post- 2016 are not comparable. The percentage of respondents who definitely or to some extent felt threatened stayed constant at 8% from 2016 to 2018.


About this data

NHS Staff Survey data:

This indicator uses data from the NHS Staff Survey. The scores were calculated as the percentage of respondents who gave a specific answer to a question, or a defined set of responses to a series of questions. The responses for each respondent were summarised for each organisation using a weighting procedure. In order to make NHS organisations’ scores comparable, individuals’ scores were weighted so that the occupational group profile of the organisation reflected that of a typical organisation of its type. For comparisons between scores over time, the data from previous years were re-weighted according to the 2018 weights.

For more information, please see the NHS Staff Survey – Basic guide for 2018 results and the Technical Guide to the 2018 Staff Survey Data.

Care Quality Commission data:

For the 2018 Urgent and Emergency Care Survey, two weights have been applied to the survey results data:

  • a trust weight to ensure that each trust contributes equally to the England average, and
  • a population weight, to make sure each trust’s results are representative of their own sample and do not over-represent particular groups, such as older respondents.

A combination of the two weights results in one single weighting, which has been applied to enable comparisons between years.

Results prior to 2016 are not comparable due to a change to the sample month, which had previously been in winter, and the inclusion of type 3 departments (such as minor injuries units or urgent care centres).

For more information please see the 2018 Urgent and Emergency Care Survey: Quality and Methodology Report.

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